Individual provider Active NPI

Olukunle Olabode-George, HHA

  • Case Manager/Care Coordinator
  • Bowie, MD
National Provider Identifier
1811327406
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
License
1811327406 Issued in DC
Practice address
10703 Vista Linda Dr
Bowie, MD 20721-4048
Phone
(240) 426-7596
NPI assigned
Nov 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 9033 DC
Case Manager/Care Coordinator 171M00000X 1811327406 DC Primary

Addresses

Primary practice location

10703 Vista Linda Dr
Bowie, MD 20721-4048

Mailing address

10703 Vista Linda Dr
Bowie, MD 20721-2106
Phone (240) 426-7596

Other identifiers 1

IdentifierTypeStateIssuer
2054827372MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1811327406DCMDCase Manager/Care Coordinator
9033DCMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Right Acess Ambulette Services Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1811327406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10703 VISTA LINDA DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207212106",
            "telephone_number": "240-426-7596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10703 VISTA LINDA DR",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207214048",
            "telephone_number": "240-426-7596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLABODE-GEORGE",
        "first_name": "OLUKUNLE",
        "credential": "HHA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-18",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "DC",
            "license": "9033",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "DC",
            "license": "1811327406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2054827372",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.